Evaluation of R-wave offset in the left chest leads for estimating the left ventricular activation delay: An evaluation based on coronary sinus electrograms and the 12-lead electrocardiogram

Journal of Electrocardiology
Hideyuki HaraJunya Ako

Abstract

The QRS duration does not always reflect the left ventricular (LV) activation delay in patients with ventricular conduction disturbances. The R-wave offset in left chest leads may more closely reflect the LV activation delay than the QRS offset. We evaluated 138 cases with left bundle branch block (LBBB, n=11), right BBB (RBBB, n=38), non-specific intraventricular conduction disturbance (n=11), narrow QRS (<120ms, n=56) and right ventricular pacing (n=22). Cases with right axis deviation (120 to 270 degrees) were excluded. The intervals from the QRS onset to the V-waves in coronary sinus bipolar electrograms (QCS) were measured, and the longest interval was defined as the QCSmax. In the 12-lead electrocardiogram, the interval from the QRS onset to the R-wave offset (QR) was measured and then averaged in leads I-aVL, II-III-aVF, V1-V2, V3-V4 and V5-V6. Significant correlations (p<0.05) were found between QCSmax and QR in I-aVL (r=0.83), II-III-aVF (r=0.51) and V5-V6 (r=0.86) in cases with a normal axis (0 to 90 degrees, n=64); and I-aVL (r=0.90), II-III-aVF (r=0.31) and V5-V6 (r=0.69) in cases with left axis deviation (-45 to -89 degrees, n=52). Overall, the QRS duration was also correlated with QCSmax (r=0.72, p<0.001); however...Continue Reading

References

Mar 1, 1954·American Heart Journal·J L RICHMAN, L WOLFF
Feb 28, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Ping JiaYoram Rudy
Mar 7, 2007·Circulation·Marcelo V ElizariMarcela Ferreiro
Jan 1, 1962·British Heart Journal·G E Dower
Mar 8, 2011·The American Journal of Cardiology·David G StraussGalen S Wagner
Jul 17, 2012·Journal of the American College of Cardiology·Matthias DupontW H Wilson Tang
Apr 2, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Freddy Del-Carpio MunozSamuel J Asirvatham

❮ Previous
Next ❯

Citations

Dec 7, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Gianni PastoreS Serge Barold

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Brain Barrier

The blood brain barrier is a border that separates blood from cerebrospinal fluid. Discover the latest search on this highly selective semipermeable membrane here.

Blood Brain Barrier Chips

The blood brain barrier (BBB) is comprised of endothelial cells that regulate the influx and outflux of plasma concentrations. Lab-on-a-chip devices allow scientists to model diseases and mechanisms such as the passage of therapeutic antibodies across the BBB. Discover the latest research on BBB chips here.

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.